What type of study is this?

This is a Systematic Review study (also classified as: Meta-Analysis).

October 13, 2025Open Access

Radiological and Clinical Outcomes of Expansive LLIF cages – Single- arm and comparative systematic revision with metanalysis

Key Points

Expandable cages achieved a mean segmental lordosis correction of 8.67°, indicating effectiveness in enhancing spinal alignment.
The subsidence rate was only 4% for expandable cages, showing a significant reduction in subsidence odds compared to static cages (OR = 0.16).
Nine studies involving 414 patients contributed to the meta-analysis, underscoring the scalability of the findings.
While expandable cages demonstrate promising outcomes, further high-quality studies are necessary to establish their long-term advantages.

Abstract

Abstract PurposeExpandable cages have been introduced in lateral lumbar interbody fusion (LLIF) to enhance segmental lordosis correction and reduce endplate damage and subsidence risk. However, evidence regarding their efficacy remains inconsistent. This systematic review and meta-analysis aimed to evaluate the ability of expandable cages to promote segmental lordosis and assess their safety profile, specifically regarding subsidence and complications, compared to static cages.MethodsA systematic search of PubMed, Google Scholar, Ovid, and BVS databases was conducted following PRISMA guidelines. Inclusion criteria were original studies using expandable cages in LLIF, reporting on segmental lordosis and/or subsidence. Quality was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analyses with cluster-robust variance estimation and subgroup/meta-regression analyses were performed using R software.ResultsNine studies with a total of 414 patients (expandable group) were included. The pooled mean segmental lordosis at last follow-up in the expandable cage group was 8.67° (95% CI: 5.34–11.9°), with no significant influence from preoperative lordosis. When compared to static cages, the mean difference in lordosis was not statistically significant (MD = − 2.56°, p = 0.27). Subsidence rate for expandable cages was 4% (95% CI: 1–15%). A significant reduction in odds of subsidence was observed with expandable cages versus static cages (OR = 0.16; 95% CI: 0.02–0.99, p = 0.049). Overall complication data were inconsistently reported and not pooled.ConclusionExpandable cages in LLIF are associated with low subsidence rates and achieve substantial segmental lordosis correction, although superiority over static cages in lordosis gain remains unproven. These findings support their use for individualized anatomic correction; however, more high-quality, prospective studies are needed to validate their clinical advantages and long-term outcomes.

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Cite This Study

Sousa et al. (Sun,) studied this question.

synapsesocial.com/papers/68ed1896f29694dd1da78e1e https://doi.org/https://doi.org/10.21203/rs.3.rs-7273973/v1

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